[0001] The present invention pertains generally to invasive medical devices which are useful
for the purpose of infusing fluid medicaments into a patient. More specifically, the
present invention pertains to medical devices which can be inserted into a vessel
of a patient's cardiovascular system. The present invention is particularly, but not
exclusively, useful for infusing fluid medicaments directly into a vessel wall.
BACKGROUND OF THE INVENTION
[0002] Depending on the particular ailment it is known in the medical field that fluid medications
can be infused directly into the wall of a vessel of a patient's cardiovascular system
with beneficial results. For example, one such application involves the administration
of medicaments into an arterial wall which will inhibit or prevent the restenosis
of plaque in the artery. Any procedure involving the direct infusion of fluid medicaments
into a vessel wall, however, requires the consideration of several factors. First,
the procedure must be safe. For instance, due to the toxic nature of some medicaments,
such a procedure must insure that only minimal amounts of medication are ever washed
away into the blood stream and not actually infused into the vessel wall. Second,
the device which infuses the medication into the vessel wall must be easy to use,
accurate in its delivery capability and reliable in its operation.
[0003] Several devices have been suggested for the purpose of infusing fluid medicaments
directly into a vessel wall. One example of such a device is disclosed in U.S. Patent
No. 5,354,279 which issued to Hofling for an invention entitled "Plural Needle Injection
Catheter". The specific device disclosed in this patent employs prebent hollow needles
which are extendable from a catheter to penetrate into a vessel wall. The extended
needles are then used for infusion of the fluid medicament. Also, U.S. Patent No.
5,364,356, was issued to Hofling for another invention entitled "Sleeve Catheter".
This second patent to Hofling discloses a device which employs a balloon expandable
sleeve that delivers fluid medication to a vessel wall. More specifically, this device
of Hofling's includes a reconfigurable sleeve which is expanded by an inflatable balloon.
It is intended that, as the sleeve expands, openings which are formed into the sleeve
spread to discharge fluid medications onto the surface of the vessel walls. Still
another example of a device for medicating a vessel wall is disclosed in U.S. Patent
No. 5,112,305 which issued to Barath et al. for an invention entitled "Catheter Device
for Intramural Delivery of Therapeutic Agents". This same device is also disclosed
in a related U.S. Patent No. 5,242,397 which issued to Barath et al. for an invention
entitled "Catheter Device and Method of Use for Intramural Delivery of Protein Kinase
C and Tyrosine Protein Kinase Inhibitors to Prevent Restenosis after Balloon Angioplasty".
Specifically, the device disclosed by Barath et al. employs a balloon which requires
an initial slow filling of the balloon with a medicament to expand the balloon and
position the balloon's surface against the vessel wall. This initial slow filling
is then followed by a rapid filling of the balloon which reconfigures tubular extensions
on the surface of the balloon for the infusion of medicaments through the tubular
extensions and into the vessel wall.
[0004] None of the above discussed devices, however, address the problem from the same perspective
as the present invention. Specifically, the present invention recognizes that it is
preferable to have a mechanism for infusing medication into a vessel wall which is
independent and separately operable from the mechanisms which position the device
in the artery and which cause at least one medication injector to penetrate into the
vessel wall. Consequently, as recognized by the present invention, it is preferable
to isolate the mechanism for actual infusion of medications into the vessel wall from
other operable mechanisms of the device. Further, the present invention recognizes
that, depending on the nature and condition of the vessel wall, it is preferable to
have the capability of selectively applying a variable force to the injectors of the
device as they penetrate into the vessel wall.
[0005] In light of the above, it is an object of the present invention to provide a device
for injecting medication into the wall of a vessel which includes a mechanism for
penetrating a vessel wall with medication delivery injectors that is separate from
the mechanism which infuses the medication into the vessel wall. It is another object
of the present invention to provide a device for injecting medication into the wall
of a vessel which can selectively vary the force that is used to penetrate the vessel
wall with a fluid medication injector. Still another object of the present invention
is to provide a device for injecting medication into the wall of a vessel which is
easy to use, relatively simple to manufacture and comparatively cost effective.
SUMMARY OF THE INVENTION
[0006] In accordance with the present invention, a device for injecting medication into
the wall of a vessel includes an inflatable PET balloon which is mounted on a multi-lumen
catheter. A flexible tubular sleeve, preferably made of polyurethane, is provided.
This sleeve effectively surrounds most of the inflatable balloon, and thereby creates
an infusion chamber between the balloon and the sleeve. To create this chamber, the
distal end of the tubular sleeve is attached directly onto the surface of the balloon,
and the proximal end of the sleeve is extended proximally from the balloon. The open
proximal end of the tubular sleeve thus establishes a port for fluid access into the
infusion chamber.
[0007] For the device of the present invention, a plurality of injectors are mounted directly
onto the sleeve and are placed in fluid communication with the infusion chamber. More
specifically, each injector includes a base plate and a hollow protrusion which projects
from the base of the injector to create a fluid channel through the injector. To establish
a fluid path from the infusion chamber through the channel of the injector, the base
of the injector is mounted onto the tubular sleeve over holes that may either be preformed
into the sleeve or formed into the sleeve after the injectors have been attached to
the sleeve.
[0008] The device of the present invention also includes a system for selectively inflating
the balloon. As intended for the present invention, the balloon inflating system can
be directly connected to a lumen of the catheter. The catheter lumen, in turn, is
in fluid communication with the interior of the inflatable balloon. Additionally,
the device includes a fluid pump which is engageable in fluid communication with the
infusion chamber between the balloon and the sleeve for injecting fluid medicaments
from a fluid source into the infusion chamber. Further, in an alternate embodiment
of the present invention, instead of having single port injectors, a plurality of
hollow protrusions can be formed onto the same base plate to create an injector having
a plurality of outlet ports.
[0009] In the operation of the device of the present invention, a guidewire is first positioned
into an artery of the patient. This is done to establish a mechanical pathway through
the artery to the site where the fluid medication is to be infused. The extracorporeal
end of the guidewire is then inserted into a lumen of the catheter and the balloon
on the catheter is advanced over the guidewire and to the site where the medication
is to be infused.
[0010] Once the balloon has been properly positioned for the infusion of fluid medicaments
into the arterial wall, the balloon is inflated. This inflation of the balloon, in
turn, urges the tubular sleeve to move outwardly with the expansion of the balloon.
This action also causes the injectors to penetrate into the arterial wall. After the
balloon has been inflated, and while the injectors remain penetrated into the arterial
wall, the fluid pump is activated to inject fluid from the fluid source into the infusion
chamber. Importantly, this pumping action also forces fluid from the infusion chamber
through the injectors and into the arterial wall.
[0011] In yet another alternative embodiment of the present invention, the tubular sleeve
which surrounds the inflatable balloon is replaced with a plurality of tubular fluid
passageways. These passageways, unlike the tubular sleeve of the previous embodiment,
are smaller in diameter than the inflatable balloon and are mounted directly onto
its exterior surface. Each passageway is oriented in a substantially longitudinal
direction and thus establishes a distal end and a proximal end for the passageway.
The distal end of each passageway is sealed to create an infusion duct, and the proximal
end of each passageway extends proximally from the balloon to establish a port for
fluid access into the fluid duct.
[0012] Similar to the previous embodiment having a tubular sleeve, each tubular fluid passageway
has at least one injector mounted directly onto its external surface and in fluid
communication with the infusion duct. The injectors are located on the surface of
the passageway such that upon inflation of the balloon, the injectors travel outwardly
in a radial direction. As the balloon continues to expand, each passageway is urged
against the arterial wall such that the injectors penetrate into the arterial wall.
[0013] The process of injecting a medicament using the embodiment having a tubular fluid
passageway is similar to the process using the embodiment with a tubular sleeve. More
specifically, the inflatable balloon is positioned along a guide wire in an artery
and inflated such that the injectors penetrate the walls of the artery. However, instead
of injecting fluid into the infusion chamber created by the tubular sleeve, fluid
is injected into the infusion duct created by the tubular fluid passageway. As fluid
is pumped into the infusion duct, it is likewise pumped out through the injectors
and infused into the arterial wall. Unlike the embodiment with the tubular sleeve,
however, each tubular fluid passageway has its own port. Thus, it is possible to administer
a variety of medicaments simultaneously, or to administer a particular medicament
through one or more selected passageways.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] The novel features of this invention, as well as the invention itself, both as to
its structure and its operation will be best understood from the accompanying drawings,
taken in conjunction with the accompanying description, in which similar reference
characters refer to similar parts, and in which:
Figure 1 is a perspective view of a patient with the catheter of the present invention
positioned in an artery of the patient for operation of the device;
Figure 2 is a perspective view of the device of the present invention;
Figure 3 is a cross-sectional view of the device of the present invention as seen
along the line 3-3 in Figure 2 and positioned in an artery of a patient for infusion
of fluid medications into the arterial wall;
Figure 4A is a perspective view of an embodiment for a single port injector of the
present invention;
Figure 4B is a perspective view of another embodiment for a single port injector of
the present invention;
Figure 5A is a perspective view of an embodiment of a multi-port injector of the present
invention;
Figure 5B is a perspective view of another embodiment of a multi-port injector of
the present invention;
Figure 6 is a perspective view of another embodiment of the present invention; and
Figure 7 is a cross-sectional view of the device of the present invention as seen
along line 7-7 in Figure 6.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0015] Referring initially to Figure 1, a device for injecting fluid medication into the
wall of a vessel in accordance with the present invention is shown and generally designated
10. More specifically, the device 10 is shown positioned in the artery of a patient
12. As will be appreciated by the skilled artisan, the device 10 is shown schematically
positioned in the patient 12, and it is to be understood that use of the device 10
is not confined to only upper body arteries and vessels but, instead, can be used
in arteries and vessels throughout the patient 12.
[0016] Figure 2 clearly shows that the components of device 10 include a multi-lumen catheter
14 which has an inflatable balloon 16 mounted thereon. Further, Figure 2 indicates
that a tubular sleeve 18 surrounds a substantial portion of the inflatable balloon
16, and that a plurality of injectors 20 are mounted onto the sleeve 18. Of these,
the injectors 20a-20b are only exemplary. For purposes of the present invention, balloon
16 is preferably made of polyethylene terephthalate (PET). Additionally, the sleeve
18 can also be made of polyethylene terephthalate (PET).
[0017] A more complete appreciation of the structural cooperation between balloon 16, sleeve
18 and the injectors 20 is provided by Figure 3 wherein it will be seen that the distal
end 22 of sleeve 18 is attached directly to the surface of balloon 16. Figure 3 also
shows that the tubular sleeve 18 substantially surrounds the balloon 16 and that the
proximal end 24 of sleeve 18 extends proximally from and beyond the balloon 16 over
catheter 14. With this structural relationship, an infusion chamber 26 is formed between
the balloon 16 and the sleeve 18. Additionally, as best seen in Figure 3, a fluid
port 27 is formed between the sleeve 18 and catheter 14 through which fluid medication
can be injected into the infusion chamber 26.
[0018] Figure 3 further shows that the distal end 28 of balloon 16 is affixed to the catheter
14, and that the proximal end of the balloon 16 closes onto the catheter 14 to create
an inflation chamber 32 in the interior of the balloon 16. A port 34 is shown which
provides fluid access into the inflation chamber 32. For purposes of the present invention,
the port 34 can be connected in fluid communication with a lumen (not shown) of the
catheter 14. Figure 3 also shows that catheter 14 is formed with a lumen 36 which
is dimensioned to receive a guidewire 38 therethrough.
[0019] Turning now to Figure 4A, an injector 20 is shown to include a base plate 40 and
a hollow protrusion 42 which projects therefrom. Further, it is seen that the end
44 of body 42 is affixed to or integral with the base plate 40. Preferably, the injector
20 is made of nickel and the protrusion 42 is formed by punching out the base plate
40. In any event, a cutting edge 46 is formed around the end of body 42 that is opposite
from the end 44 on plate 40 and the resultant structure establishes a fluid channel
48 which extends through the injector 20. As shown, the injector 20 has a substantially
cylindrical shaped protrusion 42.
[0020] In Figure 4B, another embodiment for an injector of the present invention is shown
and designated 70. Rather than having a cylindrical shaped protrusion 42 like the
injector 20, however, the injector 70 has a substantially conical shaped protrusion
72. Like injector 20, the injector 70 is preferably made of nickel and is formed to
have a fluid channel 48 which extends through the injector 70.
[0021] For a multi-port injector version of the present invention, a plurality of protrusions
42 can be formed from the same base plate. Figure 5A shows such an embodiment. Specifically,
Figure 5A shows an elongated base plate 50 from which the protrusions 42a', 42b' and
42c' have been formed. In all important respects, the protrusions 42' shown in Figure
5A are structurally the same as the protrusion 42 discussed above with reference to
Figure 4A. The only difference being that they are collectively mounted on the same
base plate 50. Similarly, Figure 5B shows a multi-port injector wherein the protrusion
72a', 72b' and 72c' have been formed from a base 50. In all important respects, the
protrusions 72' shown in Figure 5B are structurally the same as the protrusion 72
discussed above with reference to Figure 4B. Again, the only difference being that
they are collectively mounted on the same base plate 50.
[0022] For purposes of the present invention, the injectors 20 are mounted onto the sleeve
18 so that the channel 48 of each respective injector 20 is aligned with a hole 52
in the sleeve 18. This is done to establish fluid communication between the particular
injector 20 and the infusion chamber 26. As a practical matter, it may be preferable
in the construction of the device 10 to first mount the injector 20, 70 onto sleeve
18, which can be done in any manner well known in the pertinent art, such as by bonding,
and then pierce the sleeve 18 through the channel 48.
[0023] In the operation of the present invention the guidewire 38 is first positioned in
the vessel to establish a mechanical path for the device 10 to the site, as shown
in Figure 3, where fluid medications are to be infused into a vessel wall 54. Once
the balloon 16 of device 10 is properly positioned, an inflator 56 is activated to
inflate the balloon 16. As shown in Figure 2, inflator 56 is connected to the proximal
(extracorporeal) end of the device 10. Referring back to Figure 3, it will be appreciated
that, as balloon 16 is inflated, the expanding balloon 16 urges against the tubular
sleeve 18 and causes the sleeve 18 to likewise expand. Consequently, the injectors
20,70 which are mounted on the surface of sleeve 18 move radially from the catheter
14 and are embedded into the vessel wall 54.
[0024] With the injectors 20,70 embedded into the vessel wall 54, the fluid pump 58 shown
in Figure 2 is activated to pump fluid from the fluid source 60 into the infusion
chamber 26 through the port 34. Importantly, this pumping action also causes any fluid
medication which has already been pumped into the infusion chamber 26 to be expelled
through the channels 48 of injectors 20,70 and into the tissue of vessel wall 54.
[0025] After the fluid medication from fluid source 60 has been infused into the vessel
wall 54, the balloon 16 can be deflated by reversing the inflator 56. This action
will cause the balloon 16 to collapse and to thereby withdraw the injectors 20,70
from the vessel wall 54. The entire device 10 can then be withdrawn from the patient
12 over the guidewire 38.
[0026] In Figure 6, another preferred embodiment of the present invention is shown. The
perspective view in Figure 6 shows the basic components of device 100, namely, a multi-lumen
catheter 14, an inflatable balloon 16 formed to accommodate guide wire 38, and a plurality
of tubular fluid passageways 102 mounted on the external surface of balloon 16. Each
tubular fluid passageway 102 has a smaller diameter than balloon 16 and is positioned
to be substantially parallel with the longitudinal axis of balloon 16.
[0027] Figure 6 further shows that mounted on the surface of each tubular fluid passageway
102 is a plurality of injectors 70. Those injectors 70 are positioned on the outside
surface of tubular fluid passageway 102 such that when balloon 16 is inflated, injectors
70 move outwardly in a radial direction. Note, however, the showing of injector 70
is for illustration purposes only and it should be appreciated that any injector or
combination of injectors 20/70 discussed in association with the previous embodiments
may be used.
[0028] Referring now to Figure 7, the cross-sectional view of device 100 shows the tubular
fluid passageway 102 in more detail. More specifically, distal end 104 of tubular
fluid passageway 102 is sealed to create an infusion duct 108. At proximal end 106
of the tubular fluid passageway 102, port 110 provides fluid access between infusion
duct 108 and catheter 14 (not shown). Referring back to Figure 2, it is appreciated
that the proximal (extracorporeal) end of device 100 establishes fluid communication
between fluid pump 58 and infusion duct 108. Returning to Figure 7, injectors 70 are
shown mounted on the external surface of tubular fluid passageway 102. As Figure 7
further shows in detail, base 40 of injector 70 is mounted on tubular fluid passageway
102 over a corresponding hole 112. From this view, it can be appreciated that any
number of tubular fluid passageways 102 could be mounted on the external surface of
balloon 16. It is further appreciated that any number of injectors 70 could be mounted
on a single tubular fluid passageway 102.
[0029] Despite the structural differences between the preferred embodiments as discussed
above, all of the preferred embodiments operate in much the same manner. More specifically,
referring back to Figure 3, following the positioning of balloon 16 in a vessel, balloon
16 is inflated. As the balloon 16 expands, injectors 70 on tubular fluid passageway
102 are embedded into the vessel wall 54, precisely as detailed above in connection
with the previous embodiments. There is, however, a distinction between the embodiments
with respect to the connection and activation of fluid pump 58. More precisely, because
it is possible to have a plurality of tubular fluid passageways 102, it is likewise
possible to either maintain fluid communication with, or fluid isolation between,
each tubular fluid passageway 102. For example, fluid communication between tubular
fluid passageways 102 can be established by fluidly connecting ports 110 together
within catheter 14 such that port 110 of each tubular fluid passageway 102 is supplied
fluid from the same fluid pump 58. Alternatively, fluid isolation may be maintained
between each tubular fluid passageway 102 by providing each port 110 with a corresponding
lumen in catheter 14 establishing its own fluid connection to a corresponding fluid
pump 58. Consequently, it is possible to inject a variety of medicaments simultaneously
by using a plurality of fluid pumps 58.
[0030] While the particular device for injecting medication into the wall of a vessel as
herein shown and disclosed in detail is fully capable of obtaining the objects and
providing the advantages herein before stated, it is to be understood that it is merely
illustrative of the presently preferred embodiments of the invention and that no limitations
are intended to the details of the construction or design herein shown other than
as defined in the appended claims.
1. A device for injecting fluid medication,into the wall of a vessel which comprises:
an inflatable balloon having an outer surface;
means for carrying said fluid medication, said carrying means being mounted on said
outer surface of said balloon;
means for penetrating the vessel wall, said penetrating means being mounted on said
carrying means for fluid communication therewith;
means for inflating said balloon to urge said penetrating means against the vessel
wall to penetrate the vessel wall; and
means for infusing said fluid medication in said carrying means through said penetrating
means and into the vessel wall.
2. A device as recited in claim 1 wherein said penetrating means includes at least one
injector.
3. A device as recited in claim 2 wherein said injector comprises:
a base; and
a hollow protrusion having a first end and a second end, said protrusion projecting
from said base to establish a fluid channel through said base and through said protrusion,
said first end of said protrusion being affixed to said base and said second end formed
with a cutting edge.
4. A device as recited in claim 2 wherein said penetrating means comprises a plurality
of said injectors.
5. A device as recited in claim 2 wherein said injector is substantially conical shaped.
6. A device as recited in claim 1 further comprising:
a plurality of said carrying means; and
a plurality of said penetrating means, each said penetrating means being mounted on
a respective said carrying means.
7. A device as recited in claim 1 wherein said balloon is made of polyethylene terephthalate
(PET).
8. A device as recited in claim 1 wherein said carrying means includes a tubular fluid
passageway.
9. A device as recited in claim 1 further comprising a catheter formed with a lumen,
said inflatable balloon being mounted on said catheter with said lumen in fluid communication
therewith.
10. A device for injecting fluid medication into the wall of a vessel which comprises:
an inflatable balloon;
at least one tubular passageway mounted on said balloon;
at least one injector mounted on said tubular fluid passageway in fluid communication
therewith;
means for inflating said balloon to embed said injector into the vessel wall; and
means connectable with said tubular fluid passageway for injecting said medication
through said passageway and through said injector into the vessel wall.
11. A device as recited in claim 10 wherein said injector comprises:
a base; and
a hollow protrusion having a first end and a second end, said protrusion projecting
from said base to establish a fluid channel through said base and through said body,
said first end of said protrusion being affixed to said base and said second end formed
with a cutting edge.
12. A device as recited in claim 11 further comprising a plurality of said protrusions
projecting from said base.
13. A device as recited in claim 12 further comprising a plurality of injectors.
14. A device as recited in claim 11 wherein said protrusion is substantially cylindrical
shaped.
15. A device as recited in claim 11 wherein said protrusion is substantially conical shaped.
16. A device as recited in claim 10 which further comprises:
a guidewire;
a catheter formed with a plurality of lumens, one said lumen being dimensioned to
receive said guidewire therethrough for guiding and positioning said balloon in said
vessel.
17. A device as recited in claim 16 wherein one said lumen of said catheter establishes
fluid communication between said balloon and said inflating means.
18. A device as recited in claim 10 wherein said inflatable balloon is made of polyethylene
terephthalate (PET).
19. A method for injecting medication into the wall of a vessel using a device which includes
an inflatable balloon, a tubular fluid passageway, at least one injector mounted on
said tubular fluid passageway, and said injector being in fluid communication with
said tubular fluid passageway, said method comprising the steps of:
positioning said balloon in the vessel;
inflating said balloon to embed said injector into the vessel wall; and
injecting medication through said fluid passageway and through said injector into
the vessel wall.